The welfare of a nation can scarcely be inferred from a measurement of national income as defined by the GDP. Simon Kuznets

I’ve just recently finished reading Change the Story, Change the Future by David C. Korten (watch for that post on Tuesday), in which he challenges us to make decisions based on a living economy that prioritizes the health and welfare of humans before corporate profits. This was a timely read as I head into this series on the Social Determinants of Health and Emergency Management. The Social Determinants of Health, as you may have figured out by the name, provide a way to measure the overall health of people and societies. When people and societies are healthier, they are more resilient because they have a greater capacity to absorb the impact of an unexpected event.

In 1996, the editors of the British Medical Journal wrote:” The big idea is that what matters in determining mortality and health in a society is less the overall wealth of that society and more how evenly wealth is distributed. The more equally wealth is distributed the better the health of that society. “ If we believe that this is true, and the evidence is beginning to be overwhelming that it IS true, then this means that we have to redefine how we look at our economy as a whole.

I’ve experienced this first-hand in a very dark period of my life. My wife and I found ourselves barely eeking out an existence in a roach-infested 19th story apartment just south of one of the most violent intersections in the country. She was pregnant and severely ill with Hyperemesis Gravidarum, or as we called it: The Twenty Minute Lease. She got to keep food and water for twenty minutes and then she had to give it back. She was forced to keep working throughout this illness, though she thankfully had a wonderful employer who made accommodations for her and kept her working as long as possible.

Even with two of us working full-time, our combined income wasn’t enough for us to keep up with expenses. In fact, it took over fifty percent of our income just to pay our rent. We had a car, but we barely scraped together enough for gas, much less insurance or maintenance. The option of purchasing food supplements, or even healthier food was so far out of reach it was laughable. We were, in a word, poor. Our fun once consisted of me wheeling my wife through Ikea in a wheelchair because she was too weak to walk.

After a few months of this, we finally got a diagnosis and treatment plan from some wonderful doctors, and we had a little bit of hope. Then we found out what the treatment would cost. With no supplementary health coverage, we were forced to pay out of pocket for her prescription. At a daily cost of roughly $75, this wasn’t something that was even remotely possible for us. We tried to get support through the social service support system, but were denied because the medication my wife was prescribed wasn’t approved for the treatment of nausea related to pregnancy.

We were broke, with a kid on the way, and struggling to barely get by. There were moments when I seriously considered committing suicide by jumping off our balcony. I reasoned that I was worth more dead than alive, thanks to life insurance. The trials of daily living were more than enough for us, if we’d had to deal with being personally affected by a disaster or major emergency, we wouldn’t have made it.

When each day is a struggle to merely do the basics required of us as people, there is no capacity to take on the challenges posed by a disaster or major emergency.

When we measure how well we are doing as a society by our Gross Domestic Product (GDP), what we are really measuring is how much money we are making. For too many years, people have assumed that this meant that the society was doing well because they believed in the fallacy of “trickle-down” economics. We know that this doesn’t work, and we know that because we are seeing an ever-widening gap in income disparity. When a CEO makes more in an hour than an employee will make in a year, there’s a massive problem.

What then, is the relationship to Emergency Management and resilience? It’s this: people can’t do anything to increase their resilience when they can’t even meet the obligations of daily life. We can’t expect them to be able to do anything above and beyond merely existing, because that requires resources (in this case income) that they don’t have. When the choice is to fulfill an immediate need versus a possible need down the road, there really is no choice. If you had asked me to put even twenty dollars towards preparedness in the form of food that I wasn’t going to eat until years down the road (if ever), I would have laughed at you.

By the standards of what Korten calls the Sacred Money and Markets system, I should have been doing quite well. I lived in a relatively wealthy city in a first-world country with a massive GDP, and I worked for a company that had a $215 million dollar profit. In this system, I shouldn’t have had a problem building reserves, right? The problem was that the money wasn’t allocated in an equitable manner.

I was a front-line employee who helped to directly impact guest experience in positive ways. I worked outdoors in all types of weather, and held a massive amount of responsibility for the safety and well-being of the guests who visited our company every day. For this, I was paid the princely sum of $11.50/hr. My CEO on the other hand, made roughly my annual salary by his second day of work for the year. The focus at that company was on the Sacred Money and Markets, and not on the people.

If we are honestly committed to building resilience in the people, families, communities, and organizations that make up our jurisdictions then we have to address the issue of income inequality. If we serve private industry, then we must actively advocate for a living wage (not minimum wage) for our fellow employees and encourage our organization to find creative ways to build personal resiliency without costing a whole lot. In many ways, Emergency Managers who work in private industry will have a much easier time convincing their bosses about the importance of income equality to building resilience. Most companies are accustomed to thinking in five- to ten-year cycles, and almost all of them are planning on being around long past their current planning cycle.

Those who work in Emergency Management in the public sector have a much harder time. Politicians think in terms of election cycles, which means if it can’t be accomplished within four years, then it is less likely to be funded and approved. They also have the additional challenge of convincing politicians and the public alike that the needs of people who are unable to work (for whatever reason, be it disability, or lack of employability) are greater, and they are more susceptible to the effects of major emergencies or disasters. A living income for everyone (whether they are working or not) would go a long way to improving resiliency by ensuring that the basics are covered. Only once the basics of everyday life are taken care of can people start to build that capacity to be resilient.

Resilience towards and preparedness for disasters are the privilege of those who have the resources to invest in it. In order to build resilience at the foundational level in our jurisdictions, we have to make sure that people aren’t just scraping by. They have to have their basic physiologic needs met in order to work on their security-related needs such as resilience towards disasters. Only once they have guaranteed shelter, food, water, and clothing can they then begin to work on the rest of their needs.

Resilience towards and preparedness for disasters are the privilege of those who have the resources to invest in it. In order to build resilience at the foundational level in our jurisdictions, we have to make sure that people aren’t just scraping by. They have to have their basic physiologic needs met in order to work on their security-related needs such as resilience towards disasters. Only once they have guaranteed shelter, food, water, and clothing can they then begin to work on the rest of their needs.